Kikuchi Yuta, Tsutsui Masahiro, Ishido Kohei, Narita Masahiko, Ushioda Ryohei, Shirasaka Tomonori, Ishikawa Natsuya, Kamiya Hiroyuki
Department of Cardiovascular Surgery, Asahikawa Medical University, Asahikawa, Hokkaido, Japan.
J Surg Case Rep. 2022 Mar 1;2022(3):rjac050. doi: 10.1093/jscr/rjac050. eCollection 2022 Mar.
The proper surgical strategy for retrograde type A aortic dissection (RTAD) is still controversial, and some studies have reported the efficacy of frozen elephant trunk and thoracic endovascular aortic repair (TEVAR). A 68-year-old man was diagnosed with acute type A aortic dissection using enhanced computed tomography. The false lumen at the arch and ascending aorta was thrombosed, and the primary entry was placed in the descending aorta. In addition, there were malperfusions of the right renal artery and both iliac arteries. We performed TEVAR using the right femoral artery combined with the petticoat technique. At 11 days postoperatively, we observed rapid aortic remodeling at the arch and ascending aorta. The patient was discharged uneventfully after 14 days. We believe that TEVAR for RTAD is effective in appropriate patients. However, the accumulation of the number of cases and accurate strategies for patient selection are in demand.
逆行性A型主动脉夹层（RTAD）的恰当手术策略仍存在争议，一些研究报告了象鼻支架冷冻术和胸主动脉腔内修复术（TEVAR）的疗效。一名68岁男性经增强计算机断层扫描诊断为急性A型主动脉夹层。主动脉弓和升主动脉的假腔已形成血栓，原发破口位于降主动脉。此外，右肾动脉和双侧髂动脉存在灌注不良。我们采用右股动脉联合“裙边”技术实施了TEVAR。术后11天，我们观察到主动脉弓和升主动脉迅速重塑。患者在14天后顺利出院。我们认为，TEVAR治疗RTAD对合适的患者有效。然而，需要积累病例数量并制定准确的患者选择策略。
